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Workers Compensation

Scheduling an office visit as a workers compensation patient

Forms

Helpful Links

  • What is Workers Compensation?

    • The Division of Workers' Compensation (DWC) monitors the administration of workers' compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers' compensation benefits.

  • Workers Compensation CA guide for injured workers

  • DWC officers:

    • Sacramento​

      • Injured worker workshop: 8:30 a.m. to 12:00 p.m. morning session
        1:30 p.m. to 5:00 p.m. afternoon session​

    • San Francisco

      • Injured worker workshop: Held the second Wednesday of every month at 10:30 a.m.​

    • Santa Rosa

      • Injured worker workshop: ​Held the first Thursday of the month at 10:30 a.m.

    • Oakland 

      • Injured worker workshop: Held the first Tuesday of every month at 10:30 a.m.​

  • How to file an application for adjudication of claim

    • ​Complete this form if you have a disagreement with your employer or its insurance company about your case and you want it resolved by your local Workers’ Compensation Appeals Board (WCAB). Filing this form opens a case with the WCAB.

  • How to request an expedited hearing

    • ​The law requires the insurance company to authorize needed medical treatment within one working day after you submit a workers' compensation claim form, even while your claim is being investigated.
    • You can use this form to request an expedited hearing if the insurance company hasn't approved medical treatment 

   

Initial Evaluation

It is my first time having an office visit with Dr. Kimelman

follow-up office visit

I have already had an office visit

Qualified Medical Evaluation

I am scheduled to see Dr. Kimelman for a QME

consultation

I was approved for a consultation with

Dr. Kimelman

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